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Sensitive Taxpayer Data Report

The document contains sensitive taxpayer data, including a Wage and Income Transcript for the tax period of December 2022, detailing wages, federal income tax withheld, and other compensation. It also includes a Form 1099-R for distributions from pensions, highlighting the total distribution and tax withheld. The document is dated May 18, 2025, and includes identification numbers for both the employer and employee.

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0% found this document useful (0 votes)
14 views3 pages

Sensitive Taxpayer Data Report

The document contains sensitive taxpayer data, including a Wage and Income Transcript for the tax period of December 2022, detailing wages, federal income tax withheld, and other compensation. It also includes a Form 1099-R for distributions from pensions, highlighting the total distribution and tax withheld. The document is dated May 18, 2025, and includes identification numbers for both the employer and employee.

Uploaded by

f91940181
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

This Product Contains Sensitive Taxpayer

Data

Request Date: 05-18-2025


Response Date: 05-18-2025
Tracking Number: 108058376778

Wage and Income Transcript

SSN Provided: XXX-XX-2892


Tax Period Requested: December, 2022
Form W-2 Wage and Tax Statement

Employer:
Employer Identification Number (EIN):XXXXX4687
AMAZ
PO BOX

Employee:
EmployeeVs Social Security Number:XXX-XX-2892
ANDE BATI HOLG
127 SA

Submission Type:.............................................Original document


Wages, Tips and Other Compensation:.................................L17,292.00
Federal Income Tax Withheld:.........................................L1,628.00
Social Security Wages:..............................................L17,545.00
Social Security Tax Withheld:........................................L1,087.00
Medicare Wages and Tips:............................................L17,545.00
Medicare Tax Withheld:.................................................L254.00
Social Security Tips:....................................................L0.00
Allocated Tips:..........................................................L0.00
Dependent Care Benefits:.................................................L0.00
Deferred Compensation:.................................................L253.00
Code "Q" Nontaxable Combat Pay:..........................................L0.00
Code "W" Employer Contributions to a Health Savings Account:.............L0.00
Code "Y" Deferrals under a section 409A nonqualified Deferred Compensation
plan:....................................................................L0.00
Code "Z" Income under section 409A on a nonqualified Deferred Compensation
plan:....................................................................L0.00
Code "R" EmployerVs Contribution to MSA:.................................L0.00
Code "S" EmployerVs Contribution to Simple Account:......................L0.00
Code "T" Expenses Incurred for Qualified Adoptions:......................L0.00
Code "V" Income from exercise of non-statutory stock options:............L0.00
Code "AA" Designated Roth Contributions under a Section 401(k) Plan:.....L0.00
Code "BB" Designated Roth Contributions under a Section 403(b) Plan:.....L0.00
Code "DD" Cost of Employer-Sponsored Health Coverage:....................L0.00
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b)
Plan:....................................................................L0.00
Code "FF" Permitted benefits under a qualified small employer health
reimbursement arrangement:...............................................L0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):.......L0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close
of the Calendar Year:....................................................L0.00
Third Party Sick Pay Indicator:.....................................Unanswered
Retirement Plan Indicator:...............................Yes - retirement plan
Statutory Employee:.....................................Not Statutory Employee
W2 Submission Type:...................................................Original
W2 WHC SSN Validation Code:........................................Correct SSN

Form 1099-R Distributions from Pensions, Annuities, Retire or Profit-Sharing Plan

Payer:
PayerVs Federal Identification Number (FIN):XXXXX8107
FIDE
100 MA

Recipient:
RecipientVs Identification Number:XXX-XX-2892
BATI HOLG ANDE
127 SA

Submission Type:.............................................Original document


Account Number (Optional):................................................5445
Distribution Code Value:
......Early Distribution, no known exception (in most cases, under age 59 1/2)
Distribution Code:...........................................................1
Distribution Code Value:.......................................Not significant
Distribution Code:.......................................................Blank
Tax Amount Undetermined Code:......................................Not checked
Total Distribution Code:....................................Total Distribution
First Year Roth Contribution:.............................................0000
SEP Indicator:....................................IRA/SEP/SIMP box not checked
FATCA Indicator:.....................................................not FATCA
Date of Payment for Reportable Death Benefits under Section 6050Y:. 00-00-0000
Tax Withheld:...........................................................L45.00
Total Employee Contributions:............................................L0.00
Unrealized Appreciation:.................................................L0.00
Other Income:............................................................L0.00
Gross Distribution:....................................................L229.00
Taxable Amount:........................................................L229.00
Eligible Capital Gains:..................................................L0.00
Amount to IRR:...........................................................L0.00

This Product Contains Sensitive Taxpayer


Data

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